Ireland’s label as future ‘fat-man’ of Europe comes as shock

Dr Muiris Houston analyses latest WHO obesity data and questions their accuracy

Clinically, being overweight is defined as having a Body Mass Index (BMI) of 25 to 29.9; adults with a BMI of 30 and above are classified as obese. File photograph: Gareth Fuller/PA Wire

While we know Ireland has an overweight and obesity problem, being labelled the future “fat-man” of Europe has come as a shock.

Are we really shaping up to being the most obese nation in Europe in 15 years’ time - or has someone got their statistical predictions in a knot?

The World Health Organisation (WHO) data presented at the European Obesity Congress in Prague show that 85 per cent of Irish women will be overweight and 57 per cent will be classified as obese by 2030.

Some 89 per cent of men here will be overweight, with just under half being labelled obese.

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This forecast puts Irish men at the top of an “overweight” table of 53 countries, matched only by Uzbekistan.

Women in Bulgaria and Belgium are predicted to have the highest proportion of overweight and obese individuals in 2030.

The presentation was based on the WHO Global Status Report on Noncommunicable Diseases 2014 as well as hitherto unpublished modelling projections based on the work of the UK Health Forum to show overweight and obesity projections to 2030.

Clinically, being overweight is defined as having a Body Mass Index (BMI) of 25 to 29.9; adults with a BMI of 30 and above are classified as obese.

The WHO study included the obese in the overweight percentages, which can make comparisons with other study data somewhat opaque.

But there is strong evidence linking obesity with heart disease, stroke, diabetes and cancer.

Cancer associations

Up to 10 separate types of cancer have been associated with overweight and obesity, including breast, bowel and prostate tumours.

Experts have estimated that up to a third of cancers could be prevented if people maintained a healthy weight and followed current dietary and exercise guidelines.

But the figures come with a health warning: Dr Joao Breda, programme manager for nutrition, obesity and physical activity at the WHO regional office for Europe, said “the study should be used with some caution, as it was relatively small and was based on nationally available data that may not reflect the latest WHO estimates which are under further development”.

National data can be misleading when it comes to making comparisons between countries; different denominators mean that apples may inadvertently be compared with oranges. And the self-reporting of weight and other data in some studies is inevitably subjective.

For example, researchers from the department of health promotion at NUI Galway criticised a 2012 WHO report that placed Irish 11-year-old girls third in an obesity league table, on the basis that the survey here does not measure participants’ individual height and weight.

Apocalyptic predictions

The apocalyptic WHO predictions also run counter to some recent national data.

A study published last year by researchers from UCC and UCD found childhood overweight and obesity rates have plateaued in primary school-aged children in Ireland.

Analysing data from 14 studies conducted between 2002 and 2012, the researchers found childhood overweight rates had remained stable, but national obesity rates dropped from a constant 7 per cent to 4 per cent after 2008.

Although up to one in 50 children were shown to be morbidly obese, there was no significant change in the prevalence of morbid obesity over the decade.

While the severity of the WHO conclusions for Ireland may be questionable, we must not adopt a head in the sand approach to obesity.

We need to apply a whole-of-government approach to at least stabilise overweight and obesity rates, recognising the role of environment, education and tax policy as well as health in tackling the issue.

Because, as obesity expert Prof Donal O Shea noted on Wednesday, “if the WHO figures are even half correct, it’s an unthinkable scenario”.